Summary
The authors report the results of a series of 59 microdissections of the region of the foramen magnum. These dissections were made under the strict conditions of a surgical approach using an operating microscope. The major anatomic structures of the medullo-spinal junction are arranged mainly at its lateral aspect. The customary surgical approaches to the posterior cranial fossa give ready access to the cerebello-and latero-medullary cisterns. The description of the neurovascular structures contained therein assumes a particular importance because of the relative frequency of lesions developing at this level. This study deals particularly with the vertebral a. (VA), the inferior posterior cerebellar a. (IPCA), the cranial nn. IX (glossopharyngeal n.), X (vagus n.), XIc and XIs (cranial and spinal accessory n.) and XII (hypoglossal n.). The anatomy of this posterior and lateral region is characterised by the contrast between the relatively uniform course of the VA and the variable course of the IPCA, a true guideline whose very irregular arrangement accounts for the diversity of its relations with the last four cranial nn.
Résumé
Les auteurs présentent les résultats d'une série de 50 microdissections de la région du foramen magnum. Ces dissections ont été réalisées dans les conditions strictes d'un abord chirurgical sous microscope opératoire. Les éléments anatomiques importants de la jonction médullo-spinale se disposent principalement à sa face latérale. Par les voies d'abord chirurgicales usuelles de la fosse crânienne postérieure, on accède assez facilement aux citernes cérébello-et latéro-médullaires. La description des éléments vasculo-nerveux qui y sont contenus revêt une importance particulière en raison de la relative fréquence des lésions développées à ce niveau. Ce travail étudie tout particulièrement l'artère vertébrale (AV), l'a. cérébelleuse postérieure et inférieure (ACPI), les nn. crâniens IX (n. glosso-pharyngien), X (n. vague), XIc et XIs (n. accessoires parties craniale et spinale), XII (n. hypoglosse). L'anatomie de cette région postérieure et latérale de la jonction médullo-spinale est caractérisée par l'opposition entre la relative uniformité du trajet de l'AV et la variabilité de celui de l'ACPI, véritable fil conducteur dont la disposition très irrégulière explique la diversité des rapports avec les quatre derniers nn. crâniens.
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Person, H., Vallée, B., Lefèvre, C. et al. Arterial and neural relations at the posterior and lateral aspects of the medullo-spinal junction. Surg Radiol Anat 20, 177–184 (1998). https://doi.org/10.1007/BF01628892
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DOI: https://doi.org/10.1007/BF01628892